MEDICARE: HOLLY NORTHAM BURFORD MD

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZD0900X	Dermatopathology (Pathology) Physician	26350	AL
2	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	26350	AL

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0000000	OTHER	GA	RAILROAD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	51049130	OTHER	AL	BLUE CROSS BLUE SHIELD OF ALABAMA
6	051540595	OTHER	AL	BCBS
7	051540596	OTHER	AL	BCBS
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1932220308
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOLLY NORTHAM BURFORD MD

Provider Business Mailing Address
First Line	:	1010 AIRPARK CENTER DR
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37217-5200
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3512 OLD MONTGOMERY HWY
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35209-5706
Country	:	US
Telephone Number	:	205-879-2260
Fax Number	:	205-879-2261

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2007
Last Update Date	:	06/10/2021